What is NodeJS?

NodeJS is an open-source, cross-platform JavaScript run-time environment for virtualizing Java applications outside of a web browser. Put simply, NodeJS is capable of providing the user with a clean environment to run JavaScript natively.

NodeJS is so popular because of its performance and customization options. You can install modules on top of NodeJS that expand the functionality of the suite, such as creating virtualized application stacks running on a HTTP server.

With NodeJS, creating backend services for Web Applications and Mobile Apps is easy. You can create cross-platform Application Programming Interfaces (API) in a single backend service.

Is NodeJS Fit for Healthcare?

NodeJS is a highly scalable runtime perfect for data-intensive and real-time applications. A lot of big businesses use NodeJS; two of the biggest include PayPal and Netflix. PayPal in particular has been vocal in its support for NodeJS.

NodeJS has huge potential for rejuvenating legacy healthcare applications, as it makes porting them to mobile interfaces such as a cell phone or iPad is relatively straightforward. It can create significant advantages in the performance of older applications by handling multiple requests, rapid processing of NoSQL data, and near-instant response to queries.

All of this makes NodeJS the perfect choice for hospital management applications, online forms, and electronic PHI systems.

What Are the Requirements of a NodeJS Healthcare Application?

For a NodeJS application to be HIPAA compliant, the entire software stack must meet the requirements of HIPAA legislation. This includes the software application and the underlying hardware that powers the application. The NodeJS application must comply with specific details from HIPAA’s Security Rule and Privacy Rule.

Bespoke applications must follow a HIPAA compliance framework. HIPAA governance has to be at the forefront of the development process, and the application must meet the minimum security and privacy standards to ensure the confidentiality, integrity, and availability of ePHI.

Best Practice for HIPAA-Compliant NodeJS applications?

There is no predefined checklist that your developers must adhere to; instead, the application must meet the foundational principles of HIPAA’s protection of patient data.

Here are our recommendations:

Protect Your Data at All Costs

Data protection is a fundamental requirement of HIPAA compliance. Not only does the application have to be capable of being backed up, but the infrastructure used to back up the program must meet legislation standards.

Backups must be encrypted to AES-256 bit encryption, and backup applications (and data) should be protected with multi-factor authentication. Backup transfers need to be encrypted, and data redundancy requires at least 3 copies of the data: typically, the live data, a backup copy of the live data, and a replicated copy at an alternative location.

Disaster Recovery

Disaster Recovery goes hand in hand with Data Backup. DR is a key technical safeguard in HIPAA legislation, referenced directly here: “Assess the relative criticality of specific applications and data in support of other contingency plan components.”

The NodeJS community has created modules that enable high availability, such as Nodemon and Supervisor. The modules can protect against network, server, and client outages.

If a disaster strikes and you are required to invoke DR, choose a provider like Atlantic.Net that can failover live services from one data center to another with our Disaster Recovery managed service for HIPAA-compliant hosting customers.

Monitoring and Logging

Monitoring, logging, and auditing are becoming increasingly important for HIPAA compliance. Detailed verbose logging should monitor VPN activity, access controls, and file integrity to prevent unauthorized amendments of PHI. NodeJS applications should monitor usage, and intelligent SIEM applications are recommended to make sense of the extensive amount of data created.

A permission-based authority can ensure view and edit controls are granted to the correct teams. An unauthorized user accessing or changing ePHI is a HIPAA violation; therefore, strict API controls must be implemented (GET/POST/PATCH, etc). A good example is a patient website where users can access and view medical test results or request repeat prescriptions; application developers want to ensure that the patient is only able to access the data relevant to them.

Strict Authentication Controls

Control methods must be built in to protect unauthorized access to the application. Data should only be accessible by authorized personnel who have pre-approved access to ePHI. This includes any in-scope member of the covered entity (typically doctors, nurses, and physicians).

Integration with Active Directory or any other LDAP service is a great way to achieve this requirement.

Access and authorization controls are written to restrict access to flagged confidential information. Code must be implemented that prevents the export of data, such as data export to an Excel file, printing a document, or the simple use of copy & paste.

Link sensitive data to a UID instead of a username or, at the very least, architect your system so data is not traceable back to a single user on a first-name-last-name basis. The data should be encrypted and need a key to decrypt as it is created. In the event the database is exploited, this will prevent hackers from being able to see the data listed in plaintext.

Partner with a HIPAA-Compliant Hosting Provider

One of the best ways to meet many of the requirements of HIPAA is to outsource NodeJS application hosting to a HIPAA-compliant hosting provider like Atlantic.Net.

A hosting company that is HIPAA compliant will provide you with an infrastructure that is built to serve the fundamental safeguards of compliance. Make sure you choose a hosting provider that can:

• Implement physical security controls to prevent unauthorized physical access to the webserver
• Offer a Fully Managed Firewall or Web Application Firewall (WAF)
• Provide an encrypted VPN
• Provide an encrypted Data Backup plan to protect PHI
• Provide a Disaster Recovery solution to ensure that PHI is continuously available
• Provide forensic level logging of all activity of the host server (this is in addition to WordPress layer logging)
• Monitoring and alert logging
• Monitoring file changes using an Intrusion Prevention Service

How Can Atlantic.Net Help?

Are you looking for a leading HIPAA hosting provider to host your NodeJS application? Look no further than Atlantic.Net. With over 30 years of proven experience, our full suite of managed services and always available professional support team can build the perfect solution for your business or organization.

Atlantic.Net stands ready to help you attain fast compliance with a range of certifications, such as SOC 2 and SOC 3, HIPAA, and HITECH, all with 24x7x365 support, monitoring, and world-class data center infrastructure. For faster application deployment, free IT architecture design, and assessment, visit us at www.atlantic.net, call 888-618-DATA (3282), or email us at [email protected].

You can find out more information by contacting our sales team today!